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KAPLAN > QT3 > Flashcards

QT3 Flashcards

1
Q

imipramine (Tofranil)

A

possible side effects of Tofranil, a tricyclic antidepressant medication, which can be resolved by altering the dosage or changing the medication (which requires immediate notification to HCP)

Sore throat, fever, increased fatigue, vomiting, diarrhea

Expected s/e of antidepressants: Dry mouth, nasal stuffiness, weight gain

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2
Q

When pt receiving epidural, what should nurse monitor for?

A

epidural used for pain relief, monitor for urinary incontinence, hypotension, respiratory depression, and nausea and vomiting

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3
Q

aminophylline

A

treat the acute symptoms of asthma, bronchitis, emphysema, and other lung diseases

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4
Q

What is most important with a physically aggressive client in manic phase?

A

to gain control;

client has significant sympathetic nervous system stimulation and will require psychopharmacologic intervention with both sedative medications and mood-stabilizing agents

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5
Q

What should pt know about intravenous pyelogram (IVP)?

A

Contrast dye is used, so allergy to shellfish should be shared!

Tell HCP if pt has recently had an exam that included barium or X-ray dye, and if pregnant or possibly pregnant.

Cleansing enemas the evening before may be necessary to provide for adequate visualization of the urinary tract; and eating/drinking limited a certain amt of time before

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6
Q

Why might a client show attention-seeking behaviors in the ICU?

A

Pt is experiencing an increased awareness of his physical vulnerability; limitations fosters increased dependency needs that are real due to his injury;

Pt is trying to determine who is consistent and trustworthy for meeting his significant physical needs

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7
Q

Rh immune globulin (RhoGAM) is administered to prevent complications in which situation?

A

The mother is Rh-negative, the baby is Rh-positive, and there is a negative direct Coombs.

The direct Coombs test is done on a sample of red blood cells from the body. It detects antibodies that are already attached to red blood cells.

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8
Q

Walk down stairs using a cane…

A

to go down stairs, advance cane and weak leg, then strong leg; memory trick: the good goes up, the bad goes down

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9
Q

What is a hiatal hernia? classic symptom?

A

Hiatal hernia is a condition in which part of the stomach sticks upward into the chest, through an opening in the diaphragm. The diaphragm is the sheet of muscle that separates the chest from the abdomen. It is used in breathing.

Complaints of awakening at night with heartburn associated w/ reflux.

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10
Q

ulcerative colitis or Crohn’s disease

A

inflammatory bowel disease

Chronic diarrhea stools occurring 10 to 12 times per day

Diarrhea and vomiting with severe abdominal distention

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11
Q

irritable bowel syndrome

A

Pattern of alternating diarrhea and constipation

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12
Q

When does cooperative play occur in children?

A

school-aged children

(boy plays w/ large truck with another child)

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13
Q

Which age is imitative behavior shown?

A

Preschool

4-5 yo

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14
Q

What type of drug is given for ETOH withdraw?

A

Benzodiazepines decrease w/d symptoms b/c of cross-tolerance

They have anxiety-reducing, sedative-hypnotic, muscle-relaxing, and anticonvulsant actions.

Alprazolam (Xanax)

Chrlordiazepoxide (Librium) **used most often

Clonazepam (Klonopin)

clorazepate (Tranxene)

Diazepam (Valium)

Flurazepam (Dalmane)

Flurazepam (Dalmane)

Lorazepam (Ativan)

Midazolam

Oxazepam (Serax)

Quazepam (Doral)

Temazepam (Restoril)

Trazolam (Halcion)

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15
Q

MAOI drugs

A

Phenelzine (Nardil)

Tranylcypromine (Parnate)

Isocarboxazid (Marplan)

Selegiline (Emsam)

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16
Q

TCA drugs

A

Amoxapine

Amitriptyline (Elavil)

Clomipramine (Anafranil)

Desipramine (norpramin)

Doxepin (Sinequan)

Imipramine (Tofranil)

Nortriptyline (Pamlecor)

Protriptyline (Vivactil)

Trimipramine (Surmontil)

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17
Q

Early signs of ETOH withdrawal

A

Anorexia (N/V may occur)

Anxiety

Easily startled

hyperalterness

hypertension

insomnia

irritability

jerky movements

possibly hallucinations, illusions, delusions, vivid nightmares

possibly reports of “shaking inside”

seizures (7-48h after cessation of alcohol)

tachycardia

tremors

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18
Q

Assessment findings for Cushing syndrome

A

buffalo hump, hyperglycemia, hypernaetremia, weight gain, moon face, purple striae, osteoporosis, mood swings, and high susceptibility to infections

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19
Q

defense mechanism of conversion

A

expression of emotional conflicts through physical symptoms

ex) “I was unable to take my final exams because I was unable to write.”

~client has converted his anxiety over school performance into a physical symptom that interferes with his ability to perform

20
Q

When mixing Regular and NPH, how do you draw up?

A

the client should draw up the clear (regular) before the cloudy (NPH)

  • NRRN
  • air in N, air in R, draw up R, draw up N
  • insulin should be administered at room temperature; temperature extremes should be avoided
21
Q

Why are obsessive-compulsive rituals performed?

A

an attempt to avoid or alleviate increasing levels of anxiety; client does not want to repeat the act but feels compelled to do so

Example: Hand-washing helps the client avoid undesirable thoughts and maintain some control over guilt and anxiety.

22
Q

When calcium channel blocker used with other anti-HTN meds, what should be monitored?

A

verapamil (Calan) is a calcium channel blocker, depresses myocardial contractility, decreases work of ventricles and O2 demand, dilates coronary arteries; when used with other antihypertensives can cause hypotension and heart failure

23
Q

When should a three-way Foley catheter be irrigated rapidly?

A

when bright-red drainage or clots are present; irrigation rate should be decreased to about 40 gtt/min when the drainage clears

24
Q

Before you call the HCP, what should the nurse do first?

A

ASSESS the pt so she doesn’t look like a dummy.

25
Q

explanation of the myelogram procedure

A

“The test involves a lumbar puncture with injection of contrast medium, allowing x-ray visualization of the vertebral canal.”

contrast medium or air is injected into spinal subarachnoid space through a spinal puncture; identifies tumors, cysts, herniated vertebral discs

26
Q

When pt with history of epilepsy who was admitted with uncontrolled seizures comes to Ed, what is important to ask/consider?

A

Important to find out what triggered it.

What was pt doing before the seizure?

seizure may result from triggering mechanism

(loud noise, music, flickering light, prolonged reading, drugs)

27
Q

Expectations after electroconvulsive therapy (ECT) treatment

A

expected effects include headache, disrupted memory (short- and long-term), and general confused state;

backache is not a usual effect; thorough description of the pain in relation to severity, duration, location, and what makes pain better needs to be assessed and reported to the physician

28
Q

Babinski’s reflex

A

stroking outer sole of foot upward causes toes to hyperextend and fan and great toe to dorsiflex; disappears after 1 year of age

29
Q

Moro’s reflex

A

sudden jarring causes extension and abduction of extremities and fanning of fingers with index finger and thumb forming a C shape; disappears after 3 to 4 months

30
Q

Tonic neck reflex

A

when head is turned to side, arm and leg extend on that side, and opposite arm and leg flex; disappears by age 3 to 4 months

31
Q

Grasp reflex

A

touching palms of hands or soles of feet causes flexion of hands and toes; palmar grasp disappears after 3 months of age, plantar grasp lessened by 8 months of age

32
Q

What does the cerebellum control?

How can function be assessed?

A

coordination.

Have the client stand with eyes closed and observe for swaying.

Person with cerebellar tumor may state loss of balance.

33
Q

A pt with diagnosis of acute hypoparathyroidism is at risk for what?

A

tracheostomy set is the most important for the client’s safety due to risk for laryngospasm

34
Q

How does the body respond to hypovolemic shock?

A

body responds to early hypovolemic shock by adrenergic stimulation; vasoconstriction compensates for the loss of fluid, resulting in cool, clammy skin, tachycardia, tachypnea, and pale color

35
Q

A pt on MAOI who eats foods with tyramine will experience what?

A

Hypertensive crisis

headache, nausea, rapid heartbeat, vomit, dizziness, nervousness

GIVE AN ANTIHYPERTENSIVE (like Nifedipine (procardia)- Ca channel blocker)

36
Q

What can a child do at 30 months (age 2.5)?

A

child can walk up and down steps, has a steady gait, can stand on one foot momentarily, and jumps with both feet

37
Q

Dexamethasone suppression test

A

may be ordered to determine the presence of major depression

can be done to detect Cushing’s syndrome

The low-dose test can help tell whether your body is producing too much ACTH. The high-dose test can help determine whether the problem is in the pituitary gland (Cushing disease). Dexamethasone is a man-made (synthetic) steroid that is similar to cortisol. It reduces ACTH release in normal people. Therefore, taking dexamethasone should reduce ACTH level and lead to a decreased cortisol level.

38
Q

MOST helpful in determining subtle changes in the client’s level of consciousness

A

Glascow coma scale

EYE OPENING

Spontaneous
To sound
To pressure
None

VERBAL RESPONSE

Orientated
Confused
Words
Sounds
None

MOTOR RESPONSE

Obey commands
Localising
Normal flexion
Abnormal flexion
Extension
None

39
Q

How do you assess neurovascular status?

A

check pain, pallor, paralysis, paresthesia, pulselessness

40
Q

What is purpose of turn, cough, and deep breathe q 2 h?

A

primary purpose of this nursing measure is to improve and/or maintain good gas exchange, especially removal of carbon dioxide in order to prevent respiratory acidosis; promote ventilation

41
Q

Child concepts of death?

A

age 7: Death is punishment for his/her actions.

age 9: Death is inevitable and irreversible.

preschool age: Death is temporary and gradual.

adolescent age: Death as a concept based on past experience.

42
Q

Diet of child w/ CF?

A

High protein, low fat, and high calories.

impaired intestinal absorption due to cystic fibrosis necessitates a diet higher in protein and calories; fat is decreased because it may interfere with absorption of other nutrients

43
Q

electromyography (EMG)

A

“This is a noninvasive procedure that takes about 30 minutes.”

electrodes are attached to legs, length of time for impulse transmission is measured

44
Q

When is diphtheria, tetanus, and pertussis (DPT) vaccine given to infants?

A

first dose of the DPT may be given at 2 months of age, the second is given around 4 months

45
Q

manifestations of Guillain-Barré syndrome

A

classic symptoms include respiratory failure and flaccidity due to paralysis of the muscles and urinary retention due to loss of sensation

KAPLAN (13 decks)

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